California hospital where worker was murdered still an example of violence plaguing healthcare

Six years after a psychiatric technician at Napa State Hospital was murdered by a patient, regulators within the California Division of Occupational Safety and Health (Cal/OSHA) approved a new rule last fall to protect healthcare workers from on-the-job violence.

The rule took effect in April, and I covered the story in our May edition of Briefings on Hospital Safety, noting that federal OSHA officials were asking whether drafting a similar nationwide standard would be appropriate and worthwhile. Since then, the Trump administration has pared back OSHA’s regulatory agenda and classified the initiative to prevent workplace violence in healthcare settings as among the agency’s “long-term actions,” with no date set for the initiative’s next action item.

Meanwhile, the workers at Napa State Hospital continue to report frequent assaults against employees and patients alike. Cal/OSHA is investigating an attack on May 9, 2017, that left one worker with serious bodily injuries, the Napa Valley Register reported this month. Officials did not specify the circumstances of the attack, but a 26-year-old man arrested the following day had reportedly punched a staff member multiple times in the head and face, with a closed fist, before lifting a medical table above his head in an effort to use it as a weapon against the worker.

A judge ordered the hospital to release unredacted documents about the incident to Cal/OSHA after complaints that previously released documents “were so heavily redacted that they provided no meaningful information” to state investigators, the Register reported.

There were 886 assaults on staff reported at Napa State Hospital in 2015, according to the California Department of State Hospitals violence report for 2016. That figure was about the same in 2014 and 2013, but it was higher in 2012, when 1,048 assaults on staff were reported.

The 886 assaults on staff in 2015 are in addition to the 1,053 reported assaults on patients.

“That’s 1,939 reported assaults and who knows what wasn’t reported,” Michael Bartos, MD, former medical chief of staff for Napa State Hospital, wrote in a letter to the Register editor last week.

“A facility with 1,200 patients that reports over 1,000 patient assaults in a single year could be considered somewhat less than a healing environment and with almost 900 staff assaults might not be the best place to work, even with generous state benefits,” Bartos added. “Despite the problems, the majority of front line staff including nurses, psychiatry technicians, social workers, rehabilitation therapists, psychologists and psychiatrists, are dedicated professionals doing their best under difficult circumstances.”